Ohio Administrative Code

The bureau, as a means of encouraging employers to retain, rehire, or hire injured workers who have successfully completed a prescribed rehabilitation program, may make payments to such employers from the surplus fund established by section 4123.34 of the Revised Code.(A) The pay…

(A) Claims for injury, occupational disease or death incurred in the course of and arising out of participation in an approved vocational rehabilitation plan and not in the course of and arising out of any employment, may be filed for compensation and benefits.(B) The full or ave…

(A) Employers who provide compensation and benefits pursuant to section 4123.35 of the Revised Code shall furnish all eligible and feasible injured workers with vocational rehabilitation services equal to or greater in quality and content than the services administered by the bur…

(A) For purposes of this rule:(1) "Successful return to work" as a result of an approved vocational rehabilitation plan means that the injured worker has obtained employment no later than sixty days from the date of closure of the injured worker's approved comprehensive vocationa…

(A) "Benefits" means medical, surgical, nursing, and hospital attention and services and medicines, and funeral expenses as provided in sections 4123.52, 4123.55 to 4123.62, and 4123.64 to 4123.67 of the Revised Code.(B) "State insurance fund employer" are hereby defined as those…

(A) All employers granted the privilege to pay compensation and benefits directly shall demonstrate sufficient financial strength and administrative ability to assure that all obligations under section 4123.35 of the Revised Code will be met promptly. The administrator of workers…

(A) Definitions.As used in this rule:(1) "Applicant" means an employer who is applying for the privilege to pay compensation directly pursuant to section 4123.35 of the Revised Code.(2) "Certified financial statements" means financial statements that have been audited by a certif…

(A) This rule applies to a self-insuring employer that transfers to the state insurance fund.(B) Where a self-insuring employer becomes a state insurance fund employer, the employer shall be rated at the appropriate experience modifier to the employer's basic premium rate. A self…

(A) The bureau may direct that a public hearing be held on the question of revocation of a self-insuring employer's privilege of self-insurance if the employer that has elected with the approval of the bureau to pay compensation and benefits, directly thereafter fails in any one …

(A) The privilege of an employer to pay compensation and benefits directly, must be renewed annually. Beginning with the effective date of this rule, prior to renewal of the employer's privilege of self-insurance, the bureau shall re-evaluate the employer's financial strength and…

(A) The bureau shall receive all complaints, regardless of the source, concerning any employer engaged in paying compensation and benefits directly to its employees. The bureau shall transfer to the self-insuring employers evaluation board only those complaints which are not reso…

(A) The bureau shall audit the programs of employers who elect to pay compensation directly in the following situations:(1) On a random basis;(2) Whenever the bureau has grounds for believing that an employer is not in full compliance with the rules of the industrial commission o…

(A) When a self-insuring employer has provided or arranged for a necessary medical examination or evaluation, in accordance with paragraph (A) of rule 4121-03-09 of the Administrative Code, the self-insuring employer shall promptly notify the industrial commission of such action.…

The administrator shall hold a public hearing to evaluate the program for self-insuring employers in the following situations:(A) If there has been a substantial amendment of the statutes relating to self-insuring employers;(B) If decisions are rendered by the supreme court of Oh…

(A) Section 4123.352 of the Revised Code establishes a self-insuring employers evaluation board. The board shall consist of three members:(1) The member of the industrial commission representing the public, serving ex officio, as chairman.(2) A member of the Ohio self-insurers as…

(A) The administrator may delegate the authority granted to the administrator under Chapters 4121. and 4123. of the Revised Code for determining self-insuring employer matters as may be authorized. For this purpose, the administrator may appoint a self-insured review panel to pro…

(A) The bureau shall require self-insuring employers to pay a contribution to the self-insuring employers' guaranty fund as provided in this rule. The contributions due from self-insuring employers shall be established at rates as low as possible but such as will ensure sufficien…

(A) As used in this rule:(1) "Responsible self-insuring employer" or "responsible employer" means the self-insuring employer or the public school employer that enters into a construction contract and applies for permission to self-insure the construction contract. The responsible…

(A) Any employer doing business in the state of Ohio and having, by reason of operations within the territorial boundaries of this state, exposure to liability under the "United States Longshoremen's and Harbor Workers' Compensation Act," 33 U.S.C. section 901 et seq., may make a…

(A) An employer whose application for subscription to the marine industry fund has been approved by the administrator of workers' compensation as provided in rule 4123-20-01 of the Administrative Code will be issued a marine industry fund insurance policy upon payment of the init…

(A) Except as otherwise provided in this rule, premiums for marine industry fund insurance coverage are payable in advance, in annual installments, at a rate determined by the administrator of workers' compensation, subject to the approval of the bureau of workers' compensation b…

(A) The bureau will provide employers a notice of estimated annual premium no later than the first day of May preceding the policy year for which such premium is due.The notice includes:(1) The estimated payroll used by the marine industry fund to calculate the employer's estimat…

(A) When completing payroll reports pursuant to rule 4123-20-04 of the Administrative Code, an insured shall report to the marine industry fund all remuneration earned by such employees of the insured as engaged in activities constituting "maritime employment" within the meaning …

(A) At any time during the term of any marine industry fund insurance policy, and for a period of two years after the termination of any such policy, the bureau of workers' compensation has the right to make reasonable inspections of the insured's place of business, and any recor…

(A) The marine industry fund is authorized under regulations promulgated by the United States department of labor to act as an insurance carrier with respect to liabilities created by the provisions of the "Longshoremen's and Harbor Workers' Compensation Act." The marine industry…

(A) As used in sections 4131.01 to 4131.06 of the Revised Code, "operator" and "operator of a coal mine" have the same meaning as "operator" as defined in the "Federal Coal Mine Health and Safety Act of 1969," 83 Stat. 742, 30 U.S.C. 801 et seq., as now or hereafter amended, and …

(A) An employer whose application for subscription to the coal-workers' pneumoconiosis fund has been approved by the administrator of workers' compensation will be issued a coal-workers' pneumoconiosis fund insurance policy upon payment of the initial premium required for such po…

(A) When the initial application for coverage is received and accepted, the applicant will be billed initial premium based upon its estimated gross annual payroll provided by the employer on its application for subscription. Premiums for coal workers' pneumoconiosis insurance cov…

(A) The bureau will provide employers a notice of estimated premium due no later than March first preceding the policy year. BWC will estimate annual premium based on payroll from the most recently completed policy year.The notice includes all the following:(1) The estimated payr…

(A) At any time during the term of any coal-workers' pneumoconiosis fund insurance policy, and for a period of two years after the termination of any such policy, the bureau of workers' compensation has the right to make reasonable inspections of any records, payrolls, books of a…

(A) Payment of a renewal premium received after the expiration date is ineffective to continue the coverage of the insured employer.(B) The administrator of workers' compensation may, upon request, and for good cause shown:(1) Approve the original black lung coverage to take effe…

(A) No coverage will be extended to an operator whose subscription has been cancelled, except:(1) In the case of a successor operator who immediately applies for coverage effective the day following cancellation of the prior operator's coverage pursuant to rule 4123-21-01 of the …

(A) The bureau of workers' compensation is authorized under regulations promulgated by the United States department of labor to act as an insurance carrier with respect to liabilities created by Title IV of the "Federal Coal Mine Health and Safety Act of 1969," as amended. In thi…

(A) Pursuant to division (B) of section 4131.03 of the Revised Code, the director of natural resources annually may request the administrator of workers' compensation to transfer a portion of the funds from the net position of the coal-workers pneumoconiosis fund to the mining re…

(A) Offices of the bureau of workers' compensation will be located in cities as the administrator establishes and each office will be open during posted hours of operation, holidays excepted, for the receipt and filing of claim applications or any other documents and for the tran…

(A) Printed forms for all applications, reports, notices, proofs, etc., necessary for perfecting any claim before the bureau or commission will be furnished without charge by the bureau. Such forms may be obtained online or from any office of the bureau or commission.(B) Each emp…

(A) Every employer shall keep a record of all injuries and occupational diseases resulting in seven days or more of total disability or death and report them to the bureau of workers' compensation within one week of acquiring knowledge of such injury or death and within one week …

When the death of an employee is the result of a work related injury or occupational disease, the employee's dependents may file an application for death benefits. To be considered a "dependent", a person must be a member of the family of the deceased employee, or bear to the emp…

(A) Preparation and execution of forms.(1) The "First Report of Injury" form (FROI) or equivalent for applying for payment from the state insurance fund due to an injury, occupational disease, or death may be completed by the employee, employer, medical provider, or other interes…

(A) Numbering and recording.(1) Upon receipt, the bureau will assign a claim number to each initial application for benefits and provide the claim number to the claimant and employer. In cases where a deceased employee has filed, during his or her lifetime, an industrial claim fo…

(A) Compensation check issuance, delivery and endorsement.(1) Definition of claimant.As used in this rule the word "claimant" applies to an employee who sustained an injury or contracted an occupational disease in the course of and arising out of employment, to the dependent of a…

(A) During the continuance of temporary total disability, temporary partial disability, or wage loss compensation caused by an injury or occupational disease, the employer shall, at the request of the bureau of workers' compensation or the industrial commission at any time or at …

Where the bureau originally adjudicates a claim and determines that the employer is a non-complying employer, the bureau shall note the employer's non-complying employer status in the claim and the bureau order. The bureau shall notify the employer of the filing of the applicatio…

(A) Requests for subsequent actions when a state fund claim has not had activity or a request for further action within a period of time in excess of twenty-four months.(1) The bureau shall consider a request for subsequent action in a claim in the following situations:(a) Where …

(A) This paragraph of this rule applies to any employee's application for a determination of the percentage of permanent partial disability or for an increase of permanent partial disability filed on or after September 29, 2017.(1) If an employee who files an application for a de…

(A) Form C-86 motion or its equivalent shall be used to request action from the bureau or commission.(B) A motion may be submitted by the employee or the employer to seek a determination by the bureau or the commission on any matter not otherwise provided for in this chapter. It …

(A) Parties may, of their own volition, file briefs with the bureau or commission on legal questions presented in claims.(B) The bureau or commission may require parties to file briefs on legal questions presented in claims. A time certain shall be fixed for the filing of such br…